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    Juvenile Idiopathic Arthritis Symptoms

    Juvenile Idiopathic Arthritis Symptoms

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    Topic Overview

    The most common symptoms of all forms of juvenile idiopathic arthritis (JIA) include:

    • Joint pain and swelling that may come and go but are most often persistent. Symptoms must last for 6 weeks before a diagnosis of JIA can be made.
    • Joint stiffness that lasts longer than 1 hour in the morning.
    • Irritability, refusal to walk, or protection or guarding of a joint. You might notice your child limping or avoiding the use of a certain joint.
    • Often unpredictable changes in symptoms, from periods with no symptoms (remission) to flare-ups.

    Additional symptoms vary depending on which type of JIA a child has:

    Symptoms of different types of JIA
    Effects of disease Joints affected Eye disease (chronic uveitis) Other possible features
    Oligoarticular JIA (persistent or extended)
    • 1 to 4 joints affected in the first 6 months
    • Knees and ankles most commonly affected
    • Asymmetric joint symptoms (for example, one knee)
    • In persistent oligoarthritis, 4 or fewer joints are affected after the first 6 months.
    • In extended oligoarthritis, 5 or more joints are affected after the first 6 months.
    • Risk is higher, especially in children who have antinuclear antibody (ANA) in their blood
    • Rarely have whole-body symptoms
    • Uneven leg bone growth possible, resulting in muscle wasting and legs of different lengths
    Polyarticular JIA, RF-negative
    • 5 or more joints affected in the first 6 months
    • Large and small joints
    • Neck and jaw often affected
    • Symmetric joint symptoms (for example, both knees) or asymmetric
    • Risk is higher, especially in children who have antinuclear antibody (ANA) in their blood
    • Bone growth problems
    Polyarticular JIA, RF-positive
    • 5 or more joints affected in the first 6 months
    • Often affects small joints such as those in the hands
    • Symmetric and aggressive joint symptoms
    • Rare
    Systemic JIA
    • Joint swelling and pain not necessarily present at onset; eventually affects a few or many joints
    • Rare
    • Whole-body symptoms, including once- or twice-daily fever spikes; generalized body pain; rash; mild appetite loss; fatigue; weakness; and enlarged lymph nodes, liver, and spleen
    • Sometimes heart complications
    Enthesitis-related JIA
    • Both arthritis and enthesitis (tenderness where tendons and ligaments attach to bones)
    • Mostly legs and feet
    • Spine may be affected over time
    • Yes, but the frequency is unclear
    • May develop irritable bowel
    • May develop sacroiliac tenderness (where the spine meets the pelvis)
    • May develop low back and buttock pain and inflammation
    • May have antigen called HLA-B27 in the blood
    • May have family history of a condition related to HLA-B27, such as ankylosing spondylitis
    Psoriatic JIA
    • Small and medium joints
    • Asymmetric joint symptoms
    • Sometimes
    • Psoriasis
    • May have problems with fingernails or toenails, including pitting of the nails or separation of the nail from the nail bed (onycholysis)
    • May have family history of psoriasis in a close relative

    Related Information


    Other Works Consulted

    • Hashkes PJ, Laxer RM (2005). Medical treatment of juvenile ideopathic arthritis. JAMA, 294(13): 1671-1684.
    • Hsu JJ, et al. (2013). Treatment of juvenile idiopathic arthritis. In GS Firestein et al., eds., Kelley's Textbook of Rheumatology, 9th ed., vol. 2, pp. 1752-1770. Philadelphia: Saunders.


    ByHealthwise Staff
    Primary Medical Reviewer Susan C. Kim, MD - Pediatrics
    E. Gregory Thompson, MD - Internal Medicine
    Martin J. Gabica, MD - Family Medicine
    Kathleen Romito, MD - Family Medicine
    Specialist Medical Reviewer John Pope, MD - Pediatrics

    Current as ofOctober 31, 2016

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